Il1及中性粒细胞淋巴细胞比值在ANCA相关性血管炎中的作用及意义.docx

第三军医大学硕士学位论文NETs 第三军医大学硕士学位论文 NETs neutrophil extracellular traps 中性粒细胞胞外捕网 NLR neutrophil to lymphocyte ratio 中性粒细胞绝对值／淋巴细胞 绝对值 RLV renal limited vasculitis 肾脏局限性血管炎 24--hUPQ 24 hour urinary protein quantity 24 h尿蛋白定量 2 万方数据 第三军医大学硕士学位论文The 第三军医大学硕士学位论文 The role and significant of interleukin一18 and neutrophil to lymphocyte ratio in ANCA-associated vasculitis Abstract Part J The serum level and significance of interleukin-18 in patients with ANCA．associated vasculitis Background Anti—neutrophil cytoplasmic antibody(ANCA)一associated vasculitis(AAV)is a multisystem autoimmune syndrome characterized by vasculitis predominantly affecting microscopic vessels and few pauci—immune．Kidney is often involved and the major pathological changes are pauci—immune crescentic glomerulonephritis and capillary tuft fibrinoid necrosis．AAV progresses quickly and can develop to end—stage renal desease without treated in time． ANCA includes cytoplasmic-ANCA (PR3-ANCA) and perinuclear—ANCA (MPO—ANCA)and lysosomal membrane protein一2(LAMP一2)．It is the major serological marker to disease of AAV．However,ANCA couldn’t reflect the activity of AAV timely and accurately in AAV．It is important to explore the new biomarker to reflect the activity of K斟． Interleukin 18(IL一18)is a newly discovered pleiotropic pro-inflammatory cytokine．It is originally identified as an IFN—Y inducing factor because it can stimulate T helper 1 cells and natural killer cells to produce IFN-丫．The level of IL-1 8 increased in many kinds of autoimmune diseases such as type一1 diabetes，multiple sclerosis，myasthenia gravis， rheumatoid arthritis，psoriasis and systematic lupus erythematosus．It should be noted that IL一1 8 is important to reflect early renal injury．IL一1 8 is highly expressed in renal biopsies (especially in podocytes)from AAV patients．It could activate neutrophils through P38-MAPK pathway leading to hydrolase and superoxide releasing by neutrophils to damage the kidney．The serum concentration of IL-1 8 in acti